Guardian Angel Donation

The Guardian Angel Program provides an opportunity for you to say thank you in a special way to the doctors, nurses and health care professionals who deliver expert care by making a gift in their honor.

To make a donation, fill in the form below. If you would like to send a check instead, please mail to Hamot Health Foundation, 302 French St., Erie, PA 16507.

Items in bold are required.

Your Contact Information

First Name

Last Name

E-mail

Phone

Mailing Address

Street

City

State

ZIP

Guardian Angel

Name of Physician, Nurse or UPMC Hamot Employee

Department

Note of Appreciation

Tribute, Joint and Matching Donations

If you would like to give in honor or memory of someone, have a joint donation or your employer matches donated funds, click on the appropriate box below.

Tribute Donation

Tribute Donation

If you are giving a tribute donation, please provide the contact information of the person to be notified of your gift.

My gift is in Honor/Tribute of

My gift is a Memorial to

Please Notify (Name)

Address

City

State

ZIP

Joint Donation

Joint Donation

If this is a joint donation, please provide the name of the person who is donating together with you.

Name

Matching Funds

Matching Funds

If you have matching funds available or you are not sure, please provide the name of who will be matching below.

Name

Donation Details

Amount

Donor Recognition

Provide your name as you would like it to appear in our recognition publications. If you wish to be listed as anonymous, please type the word 'anonymous' in the text box.